Nutrition Transition & Double Burden of Malnutrition in Africa: A Case Study of Four Selected Countries with Different Income Levels (P10-074-19)

Abstract

ObjectivesDisease and lifestyle patterns have been changing rapidly worldwide including Africa due to recent changes in economic growth and urbanization. However, research related to the effects of these changes on nutrition status in Africa is limited. This study investigated the shifts in nutritional status (undernutrition, overweight, obesity) in children and adults in 4 carefully selected low-, middle- and high income countries in Africa, identified factors associated with the shifts, and provided recommendations for future work. MethodsMalawi, Kenya, Ghana, and South Africa were selected based on their economic status, population size, urbanization, etc. Nationally representative data was obtained from sources such as 2017 Global Nutrition Report, Demographic Health Surveys (DHSs), Food and Agriculture Organization Corporate Statistical Database (FAOSTAT), and World Health Organization (WHO). The prevalence of underweight, overweight and obesity (ov/ob), and some ratios were assessed and compared across the countries between 1998 and 2016. ResultsVaried nutrition status and shifts were observed among the countries during 1998–2016. Countries with the higher economic status also had higher prevalence and faster increasing trends of ov/ob. South Africa had the highest GDP and highest ov/ob rates in children <5, children 5-18, and adults >18 (13.3%, 24.7%, and 51.9% respectively). Malawi, with the lowest GDP, had the highest stunting rate (37%). In each country, but most notably in South Africa, trends indicated the increasing ov/ob rate (11.8%) was much greater than the declining underweight rate (2.4%). Slight declines in overweight in children under 5 years were observed in Malawi, Kenya, and Ghana, which might be due to reduced stunting rates. Sex differences existed in older children and adults, with higher rates of ov/ob in females and undernutrition among males. ConclusionsNutrition shifts, heavily influenced by economic development, are rapidly occurring in sub-Saharan Africa. The double-burden of malnutrition posts prioritization challenges for policymakers. Because undernutrition is now a declining issue, the focus should be shifted towards prevention of obesity, at least in higher income countries in Africa. Funding SourcesThe study is funded in part by a center grant from the US National Institutes of Health (NIH, U54HD070725).